A 30-year-old woman was evaluated for recurrent fever and pancytopenia. 18F-FDG PET/CT revealed diffuse skeletal involvement, consistent with disseminated metastatic disease. Histopathologic analysis of a bone marrow bio...A 30-year-old woman was evaluated for recurrent fever and pancytopenia. 18F-FDG PET/CT revealed diffuse skeletal involvement, consistent with disseminated metastatic disease. Histopathologic analysis of a bone marrow biopsy confirmed the diagnosis of neuroblastoma. The patient subsequently received neuroblastoma-targeted chemotherapy. Following treatment, she participated in a clinical trial and underwent an 18F-MFBG PET/CT examination, which demonstrated multiple skeletal metastases. Notably, neither imaging modality identified a primary tumor site. This case illustrates that metastatic neuroblastoma in adults may present with extensive osseous involvement in the absence of a detectable primary tumor, even after comprehensive functional imaging with both 18F-FDG and 18F-MFBG.
Sahafi P, Kiamanesh Z, Samadi MH
… +2 more, Soltani E, Sadeghi R
Clin Nucl Med
· 2026 Mar · PMID 41941229
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Primary urethral carcinoma is an uncommon malignancy, representing <1% of all urologic cancers. Lymph node staging is an integral part of urethral carcinomas; however, sentinel node mapping has not been reported in this...Primary urethral carcinoma is an uncommon malignancy, representing <1% of all urologic cancers. Lymph node staging is an integral part of urethral carcinomas; however, sentinel node mapping has not been reported in this malignancy before for urethral transitional carcinoma (TCC). We report a 77-year-old woman with urethral transitional cell carcinoma in whom SLNB revealed bilateral inguinal lymph node involvement. Although frozen section analysis confirmed metastasis, final surgical pathology demonstrated no residual primary tumor. This case illustrates the clinical utility of SLNB in detecting occult nodal disease and its role in guiding surgical management of urethral carcinoma.
Clin Nucl Med
· 2026 Mar · PMID 41940837
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A 66-year-old man with a history of prostate adenocarcinoma treated with radiotherapy and endocrine therapy underwent 18F-FDG and 68Ga-PSMA PET/CT. Both scans showed marked radiotracer uptake, raising suspicion for disea...A 66-year-old man with a history of prostate adenocarcinoma treated with radiotherapy and endocrine therapy underwent 18F-FDG and 68Ga-PSMA PET/CT. Both scans showed marked radiotracer uptake, raising suspicion for disease recurrence. However, subsequent transurethral resection of the prostate was performed for treatment with concurrent pathologic biopsy, confirmed only chronic inflammation accompanied by focal necrosis and calcification, emphasizing the false-positive risk of these modalities in nonmalignant conditions.
Clin Nucl Med
· 2026 Mar · PMID 41940836
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A major complication of advanced prostate cancer is malignant obstructive uropathy, a condition that can precipitate post-renal acute kidney injury and ultimately require hemodialysis intervention. We present a striking...A major complication of advanced prostate cancer is malignant obstructive uropathy, a condition that can precipitate post-renal acute kidney injury and ultimately require hemodialysis intervention. We present a striking imaging example of a patient with metastatic castration-resistant prostate cancer (mCRPC) and dialysis-dependent renal failure who demonstrated marked tumor regression and discontinuation of dialysis following 177Lu-PSMA radioligand therapy.
Metaplastic breast carcinoma is a rare, aggressive malignancy that most commonly exhibits a triple-negative phenotype; its clinical, pathologic, and imaging diagnosis can be challenging, and treatment outcomes and progno...Metaplastic breast carcinoma is a rare, aggressive malignancy that most commonly exhibits a triple-negative phenotype; its clinical, pathologic, and imaging diagnosis can be challenging, and treatment outcomes and prognosis are generally poor. Here, we report the discrepant imaging findings on 18 F-FDG PET/CT and 68 Ga-FAP-2286 PET/CT in a 47-year-old woman with metaplastic carcinoma of the breast with mesenchymal differentiation and pulmonary and lymph node metastases: tracer uptake in both the primary lesion and metastatic sites was markedly higher on 18 F-FDG PET/CT than on the corresponding 68 Ga-FAP-2286 PET/CT.
Clin Nucl Med
· 2026 Mar · PMID 41940816
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An 8-year-old girl was diagnosed with epileptic encephalopathy, which progressed to Lennox-Gastaut syndrome. She experienced daily episodes of behavioral arrest and frequent drop attacks, resulting in cuts and injuries....An 8-year-old girl was diagnosed with epileptic encephalopathy, which progressed to Lennox-Gastaut syndrome. She experienced daily episodes of behavioral arrest and frequent drop attacks, resulting in cuts and injuries. In 2019, she underwent a lesionectomy to remove a cystic lesion located at the edge of the right parietal lateral ventricle atrium, accompanied by parieto-occipital disconnection and posterior callosotomy. Anatomopathological analysis showed an ependymal cyst, a rare benign neuroepithelial lesion. Postoperative PET/MRI imaging revealed the absence of metabolic activity in the right parietal region and the lateral and polar regions of the basal occipital lobe, consistent with the deafferented cortex.
Clin Nucl Med
· 2025 Dec · PMID 41937553
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Glucagonoma is a rare pancreatic neuroendocrine tumor characterized by necrolytic migratory erythema (NME), diabetes, and weight loss. Diagnosis can be difficult, especially when serum glucagon levels are normal. We repo...Glucagonoma is a rare pancreatic neuroendocrine tumor characterized by necrolytic migratory erythema (NME), diabetes, and weight loss. Diagnosis can be difficult, especially when serum glucagon levels are normal. We report a case of a 49-year-old woman with chronic pruritic skin lesions and significant weight loss. Skin biopsy confirmed NME, while laboratory tests showed hyperglycemia and normal serum glucagon. A 68Ga-DOTANOC PET/CT scan revealed a somatostatin receptor-expressing mass in the pancreas. Surgical resection confirmed a grade 2 pancreatic NET consistent with glucagonoma, emphasizing that normal glucagon levels do not rule out glucagonoma and highlighting the utility of SSTR PET/CT in diagnosis.
Clin Nucl Med
· 2026 Jun · PMID 41931744
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Primary extraskeletal Ewing sarcoma is rare. This report presents a 47‑year‑old man with primary extraskeletal Ewing sarcoma located in the posterior mediastinum, who underwent both 18 F-FDG and 18 F-FAPI-74 PET/CT imagi...Primary extraskeletal Ewing sarcoma is rare. This report presents a 47‑year‑old man with primary extraskeletal Ewing sarcoma located in the posterior mediastinum, who underwent both 18 F-FDG and 18 F-FAPI-74 PET/CT imaging. The scans demonstrated a notable discordance in tracer uptake: the mass exhibited intense FDG avidity, while FAPI uptake was relatively low and confined to the peripheral rim. The biopsy pathology confirmed the diagnosis of Ewing sarcoma.
Perrone E, Greifenstein L, Ghai K
… +2 more, Wirtz RM, Baum RP
Clin Nucl Med
· 2026 May · PMID 41921940
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We present the first metastatic castration-resistant prostate cancer (mCRPC) patient, heavily pretreated with multiple systemic and radioligand therapies, who received [212Pb]Pb-PSMA radioligand therapy (PRLT) combined w...We present the first metastatic castration-resistant prostate cancer (mCRPC) patient, heavily pretreated with multiple systemic and radioligand therapies, who received [212Pb]Pb-PSMA radioligand therapy (PRLT) combined with the metabotropic glutamate receptor (mGluR)-inhibitor Riluzole due to disease progression. This novel combination, aimed at targeting glutamine addiction in prostate cancer and exploiting radio-sensitization, was well tolerated leading to partial remission of the disease, decrease in PSA values, and stability of symptoms. This represents the first-in-human clinical application of [212Pb]Pb-PSMA PRLT combined with mGluR inhibition in mCRPC, representing a promising therapeutic strategy for advanced, treatment-refractory, progressing patients, supported by molecular imaging and clinical benefit.
Clin Nucl Med
· 2026 May · PMID 41921939
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Here we present the FDG PET/CT findings of a case of coexistence of renal replacement lipomatosis and xanthogranulomatous pyelonephritis in a 62-year-old man with a history of renal transplantation. The image showed an e...Here we present the FDG PET/CT findings of a case of coexistence of renal replacement lipomatosis and xanthogranulomatous pyelonephritis in a 62-year-old man with a history of renal transplantation. The image showed an enlarged transplanted kidney with marked fatty proliferation within the renal sinus and hilum with heterogeneous mild FDG uptake, and a cystic nodule in the inferior pole with high FDG uptake in the cystic wall, suggesting an infection. The final pathologic diagnoses of these two lesions were renal replacement lipomatosis and xanthogranulomatous pyelonephritis, respectively.
Clin Nucl Med
· 2026 May · PMID 41921938
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A 79-year-old patient with a history of renal cell carcinoma (RCC) presented with nonspecific upper abdominal pain 6 months ago. Contrast-enhanced CT and MRI did not reveal definitive evidence of malignancy. However, 68G...A 79-year-old patient with a history of renal cell carcinoma (RCC) presented with nonspecific upper abdominal pain 6 months ago. Contrast-enhanced CT and MRI did not reveal definitive evidence of malignancy. However, 68Ga-LNC1007 (68Ga-FAPI-RGD) PET/CT demonstrated a significant radiotracer-avid focus in the tail of the pancreas, initially interpreted as a metastatic RCC lesion. Surgical pathology later confirmed the lesion as a neuroendocrine neoplasm (NEN). This case illustrates that neuroendocrine tumors may occasionally be missed by conventional imaging modalities or suspected as other malignancies in certain scenarios, and highlights the potential diagnostic value of 68Ga-LNC1007 PET/CT in detecting neuroendocrine tumors.
Clin Nucl Med
· 2026 May · PMID 41921937
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A 74-year-old woman underwent 18F-FDG PET/CT scan for the diagnostic work-up of multiple myeloma. Unexpectedly, intense radiotracer uptake in the tongue suspicious for malignancy, which was histopathologically confirmed...A 74-year-old woman underwent 18F-FDG PET/CT scan for the diagnostic work-up of multiple myeloma. Unexpectedly, intense radiotracer uptake in the tongue suspicious for malignancy, which was histopathologically confirmed as a parakeratotic squamous epithelial proliferation without cytologic atypia.
Eshghi A, Stratford R, Vallurupalli S
… +1 more, Eichhorn J
Clin Nucl Med
· 2026 May · PMID 41921936
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A patient underwent 99mTc-pyrophosphate (PYP) imaging to evaluate for suspected cardiac amyloidosis. Planar imaging demonstrated diffusely increased radiotracer uptake throughout the left ventricular myocardium. On SPECT...A patient underwent 99mTc-pyrophosphate (PYP) imaging to evaluate for suspected cardiac amyloidosis. Planar imaging demonstrated diffusely increased radiotracer uptake throughout the left ventricular myocardium. On SPECT/CT, these regions of uptake corresponded to extensive myocardial calcifications. Patient had a history of severe myocarditis a year prior with extensive fibrosis documented by cardiac MRI. This case underscores the importance of SPECT/CT correlation in differentiating true cardiac amyloid deposition from false-positive PYP uptake due to dystrophic myocardial calcification.
Clin Nucl Med
· 2026 May · PMID 41921935
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A 51-year-old woman presented with intermittent upper abdominal pain for two years and unintentional weight loss recently. Gastroscopy revealed a large cardia mass protruding into the gastric lumen. CT examination sugges...A 51-year-old woman presented with intermittent upper abdominal pain for two years and unintentional weight loss recently. Gastroscopy revealed a large cardia mass protruding into the gastric lumen. CT examination suggested malignant gastric tumor. Subsequently, ¹⁸F-FDG PET/CT demonstrated heterogeneous intense uptake in the gastric mass. Pathologic examination identified a gastric pyloric gland adenoma by immunohistochemistry. The lesion was resected locally, and the patient recovered well.
Zhang J, Cheng X, Wang H
… +2 more, Zhao J, Ding J
Clin Nucl Med
· 2026 May · PMID 41921934
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A 57-year-old woman presented with fever was incidentally found to have a large hepatogastric space mass with coarse calcifications on CT, accompanied by a markedly elevated serum CA-125 level (3082 U/mL). 18F-FDG PET/MR...A 57-year-old woman presented with fever was incidentally found to have a large hepatogastric space mass with coarse calcifications on CT, accompanied by a markedly elevated serum CA-125 level (3082 U/mL). 18F-FDG PET/MR revealed intense metabolic activity (SUVmax= 10.82) and restricted diffusion without ascites, while both ovaries appeared unremarkable. Pathology confirmed primary peritoneal high-grade serous carcinoma (PPHGSC). This case illustrates atypical imaging features of this rare malignancy, including lesion localization, coarse calcification, and absence of ascites.
Clin Nucl Med
· 2026 May · PMID 41921933
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Fibroblast activation protein (FAP) has emerged as a promising molecular target for theranostic strategies. Here is a case of a 37-year-old woman with poorly differentiated pancreatic adenocarcinoma with lymph node metas...Fibroblast activation protein (FAP) has emerged as a promising molecular target for theranostic strategies. Here is a case of a 37-year-old woman with poorly differentiated pancreatic adenocarcinoma with lymph node metastasis who received 1 cycle of gemcitabine plus nab-paclitaxel, but relapsed a year ago. She then received 3 cycles of 177Lu-FAP-2286 treatment, in combination with 6 cycles of gemcitabine plus nab-paclitaxel therapy. After that, the patient received an additional 2 cycles of 225Ac-FAP-2286 treatment. A follow-up 68Ga-FAP-2286 PET/CT scan revealed complete metabolic response of the lesions, and no severe adverse reactions were reported.
Clin Nucl Med
· 2026 May · PMID 41921932
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A ⁶⁸Ga-DOTATATE PET/CT scan was performed on a 40-year-old woman with suspected tumor-induced osteomalacia (TIO), who presented with progressive bone pain, multiple fractures, and hypophosphatemia. The scan revealed a so...A ⁶⁸Ga-DOTATATE PET/CT scan was performed on a 40-year-old woman with suspected tumor-induced osteomalacia (TIO), who presented with progressive bone pain, multiple fractures, and hypophosphatemia. The scan revealed a solitary focus of intense somatostatin receptor avidity within the right lower abdominal wall musculature. No other suspicious lesions were identified. On the basis of this finding, the tumor was surgically resected, and histopathology confirmed a phosphaturic mesenchymal tumor (PMT). Postoperatively, the patient's serum phosphate levels normalized. This case underscores the paramount value of ⁶⁸Ga-DOTATATE PET/CT in localizing occult PMTs, even in uncommon locations like the abdominal wall, guiding definitive surgical management.
Clin Nucl Med
· 2026 May · PMID 41921931
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Primary splenic angiosarcoma is a rare, aggressive malignancy carrying a poor prognosis. A 65-year-old woman with a pathologically confirmed well-differentiated splenic angiosarcoma developed liver metastases 5 months in...Primary splenic angiosarcoma is a rare, aggressive malignancy carrying a poor prognosis. A 65-year-old woman with a pathologically confirmed well-differentiated splenic angiosarcoma developed liver metastases 5 months into follow-up. Subsequent 18F-FDG and 68Ga-FAPI PET/CT imaging revealed a "dual-negative" pattern, demonstrating no significant radiotracer uptake in the metastatic liver lesions. Despite well-differentiated histology, the tumor showed rapid progression, confirming aggressive behavior in well-differentiated angiosarcoma. The high-grade splenic angiosarcoma demonstrated negative findings on dual-tracer PET/CT, underscoring that vigilance and comprehensive multimodal evaluation are crucial for such occult malignancies.
Clin Nucl Med
· 2026 Jun · PMID 41915797
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We describe FDG PET/CT and PET/MRI findings in a case with severe stenosis of the left posterior cerebral artery and impaired perfusion of the left posterior cerebral artery territory as evidenced by CT angiography and C...We describe FDG PET/CT and PET/MRI findings in a case with severe stenosis of the left posterior cerebral artery and impaired perfusion of the left posterior cerebral artery territory as evidenced by CT angiography and CT perfusion. FDG PET/CT and PET/MRI showed a wedge-shaped intense activity in the left posterior cerebral artery territory with mild parenchymal atrophy and no infarction. The intense FDG activity in the left posterior cerebral artery territory may be caused by activation of glucose transporters and elevated glycolytic activity as compensation for hypoperfusion resulting from the stenosis of the left posterior cerebral artery.